CSP LSP Test

Question 1

CSP Myotomes: how many s hold?

Answer 1

6s

Question 2

CSP Dermatome (C2-T1)

Answer 2

C2 ear to ear round back of head

C3 SC jt anteriorly round base of neck back to SC jt

C4 SC jt to AC joint

C5 1/3 down humerus to 1/3 down radius

C6 anterior shoulder in line to base of thumb, then thumb

C7 middle of palm to 2nd, 3rd and 4th digits

C8 Ulna styloid to tip of LF

T1 2/3 down humerus to 2/3 down radius

Question 3

CSP Myotomes (C1-T1)

Answer 3

C1 – Cervical flexion

C2 – Cervical extension

C3 – Cervical side flexion

C4 – Shoulder girdle elevation

C5 – Shoulder abduction

C6 – Elbow flexion

C7 – Elbow extension

C8 – Thumb extension

T1 – Finger adduction

Question 4

Reflexes is ?

Answer 4

a reflex arc involving the spinal cord

Question 5

CSP Reflexes (3)

Answer 5

Biceps, C5-6

Triceps C7-8

Brachioradialis C6

Question 6

CSP UMN lesion test (2)

Answer 6

Hoffman’s Sign
Babinski/Plantar Response

Question 7

Babinski/Plantar Response

Answer 7

UMN lesion.

With the point of the reflex hammer draw up the lateral border of foot and underneath toes – slowly.

Normal response = down going (flexion)
Abnormal response = extension/dorsiflexion of big toe and possible splaying of toes.

Question 8

Hoffman’s Sign

Answer 8

UMN lesion and corticospinal pathway dysfunction.

Pt sitting or standing. Cradle patients’ hand so it is relaxed and the fingers are slightly flexed. Hold the patients’ middle finger just proximal to the DIP joint and flick the nail.

Abnormal response = quick flexion and ADD of the index finger and thumb.

Question 9

Muscle length tests for muscles prone to ____

Answer 9

tightness

Question 10

CSP Muscle length tests (2)

Answer 10

Upper trap
Levator Scap

Question 11

Upper trap muscle length test

Answer 11

Supine, passive contralateral lateral flexion, ipsilateral rotation & neck flexion: depress shoulder

Question 12

Levator sca Muscle length Test

Answer 12

Supine, passive contralateral lateral flexion & rotation, neck flexion:

depress shoulder

Question 13

2 types of MUSCLE TESTS

Answer 13

length and strength

Question 14

CSP Muscle strength tests

Answer 14

Neck flexor endurance test

Question 15

Neck flexor endurance/strength test

Answer 15

Supine, retract chin, lift head 2cm. Time to chin thrust is measured in seconds. Average no neck pain scores = 15-20 seconds.

Question 16

CSP special test (6)

Answer 16

UMN lesion:
Hoffman’s Sign
Babinski/Plantar Response

radiculopathy:
Spurling Test
ULTT1
Cervical Distraction Test
Shoulder ABDuction relief test

Question 17

CSP tx (5)

Answer 17

Central Pa
Unilateral PA
NAGS
SNAGS
TP release

Question 18

Spurling Test (骨刺)

Answer 18

Passive extension and lateral flexion towards symptomatic side – add axial compression if needed.

+ve = symptoms are reproduced

Question 19

ULTT1: (median nerve)

Answer 19

pt lying supine, you perform the mvmt passively. looking at the pt and check for feedback. Stop with apprehension.

Shoulder girdle fixation, 90 DEG shoulder ABD, FA sup, wrist and finger EXT, shoulder ER, elbow EXT, lateral flexion of the neck to contralateral and ipsilateral side.

+ve if Sx is reproduced; contralateral flexion increases the Sx or ipsilateral flexion decreases Sx

Question 20

Cervical Distraction Test

Answer 20

pt lying in supine, neck slightly flexed, place hand on pt’s chin and occiput, gradually apply a distraction force (pulling towards you).

+ve if Sx decrease

Question 21

Shoulder abduction relief test

Answer 21

Hands on head test
pt seated (long sitting or edge of bed), ask pt to place hand of the affected side on the head.

+ve test if Sx derease

Question 22

What are the CES signs?

Answer 22

saddle area sensation
bladder - retention or overflow incontinence
Loss of anal sphincter control
sexual dysfunction - sensation/erectile dysfunction

Question 23

Common cause of CES (3)

Answer 23

disc herniation, spinal stenosis, and tumours

Question 24

LSP: Movements tested with overpressure at the end of range if __ and ____: flexion, extension, lateral flexion (rotation not commonly assessed).

Answer 24

full and pain-free

Question 25

LSP clearing what joint and how

Answer 25

Clearing SIJ – Cluster testing with pain provocation tests​

Thigh thrust​

Hip in 90 flex, compression through shaft femur​

Then ADD & ABD hip (still 90fl) and compress

Lat Ankle on knee (figure of 4 knee out laterally, hip LR) gentle pressure on knee towards ground

Question 26

LSP reflex testing (2); what nerve root

Answer 26

knee (L3/4)
Ankle (S1/2)

Question 27

Reflexes: Tendon must be in ___ and ____. ​

Strike the tendon using the reflex hammer with a single stroke. Repeat ____. Compare with the other side.

Answer 27

mid range and relaxed
3x

Question 28

___ cause hyporeflexia

Answer 28

LMN lesions (PNS)

Question 29

____ cause hyper-reflexia

Answer 29

UMN lesions (CNS)

Question 30

LSP myotome (L2-S2)

Answer 30

L2 – Hip flexion​

L3 – Knee extension​

L4 – Ankle dorsiflexion​

L5 – Great toe extension​

S1 – Ankle plantarflexion ​

S2 – Knee flexion

Perform an isometric contraction. ​

Compare to the contralateral side

Question 31

LSP dermatome

Answer 31

L1 - back, over trochanter ad groin
L2 - back, front of thigh to knee
L3 - back, upper buttock, ant thigh and knee, medial lower leg
L4 - medial buttock, lateral thigh, medial leg, dorsum of foot, big toe
L5 - buttock, post and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, 1-2-3 toes

S1 - buttock, thigh, leg post
S2 - same

Question 32

LSP why do vascular testing?

Answer 32

to rule out its a vascular cause. e.g. peripheral vascular disease PVD, abdominal aortic aneurysm AAA

Question 33

LSP pulse testing name. describe.

Answer 33

dorsalis pedis pulse. palpation on the dorsum of the foot in the 1st intermetatarsal space just lateral to the extensor tendon of the great toe

impalpable = a sign of peripheral artery insufficiency

Question 34

LSP what is PVD

Answer 34

Reduced blood flow to the arms/legs ​

Due to narrowed vessels from fat deposits​

Question 35

PVD - Symptoms may mimic peripheral symptoms from LBP, consider in relation to ______ and ____

Answer 35

reduced skin sensation; PMH

Question 36

LSP what is AAA, why is it important to rule out

Answer 36

Abdominal aortic aneurysm - bulging of a section of the aorta – requires surgery before it ruptures​.

can cause LBP

Question 37

AAA Sx

Answer 37

May have bilat peripheral symptoms, PMH heart issues, night pain

Question 38

AAA Onward referral if (3)

Answer 38

> 50 years, night pain, clinical presentation not aligned with mechanical pain on assessment

Question 39

LSP - SLR
Neural tension test to assess for_____

Look for _____ and note _____ of hip flexion

Desensitise with ____

Answer 39

lumbosacral nerve root irritation​;

reproduction of patients symptoms; degree of hip flexion​

Plantar Flexion​

Question 40

LSP slump test procedure

Answer 40

Hands behind back​

Adopt a slump position (teenage slump) with chin to chest​

Gently extend knee​

Gently dorsi-flex ankle​

Question 41

slump test Desensitise with _____

Answer 41

cervical extension

Question 42

what are we looking for in palpation of LSP

Answer 42

muscle spasm

soft tissue changes
- increase in temp or sweating (inflammatory disorder)
- dry skin (although sweating can be present; autonomic changes)

Question 43

definition and full name of PAIVMs

Answer 43

Passive accessory intervertebral movements

producing movements in directions that can not be produced actively in isolation but nonetheless need to be available for active movements to occur.

Question 44

PAIMs e.g.

Answer 44

central and unilateral PA

Question 45

PAIVMs Symptoms / Objective findings: ​

Answer 45

Normal, hypomobile / hyper mobile / stiff ​

Pain, spasm, normal, tender, stiff ​

Prominent Segment or Depressed segment